Provider Demographics
NPI:1720054885
Name:STECZO, ANDY STEPHAN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:ANDY
Middle Name:STEPHAN
Last Name:STECZO
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 HEATHER FIELDS CT
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-3379
Mailing Address - Country:US
Mailing Address - Phone:904-264-8083
Mailing Address - Fax:
Practice Address - Street 1:1600 HEATHER FIELDS CT
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32003-3379
Practice Address - Country:US
Practice Address - Phone:904-264-8083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3336572367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered